A blog about Oral and Maxillofacial Surgery

What most people do not realize about losing a tooth is that they also begin the process of bone loss in the jaw. This bone loss occurs in multiple directions and people can lose up to 60% of the surrounding bone in less than 1 year. This can be especially troublesome if the tooth that is lost is one of the front teeth. Dental implants are the only tooth replacement option that helps to maintain the bone in the jaws and prevent bone loss.

This is a excerpt from a Q and A that I have been participating in. It is probably the one thing that people don’t understand about losing teeth. This is not something that has been discussed by a lot of dentist with their patients regarding tooth loss.

This is very important because it directly effects the future replacement of that missing tooth. When you start losing bone, you start the difficult process of trying to get it back. What could be taken care of very easily early on may require extensive bone grafting years later. Luckily, with the bone grafting techniques that we have available today, we can almost always still replace missing teeth with dental implants.

On the flip side, we could replace it early at the time that it needs to be removed and avoid the need for grafting. The major upsides here are time and money, and we all know that in todays society we would all like to save a little of both.

Dental implants provide us with a tremendous tool to replace missing teeth. With dental implants we are able to give you back a tooth, and with that tooth, a quality of life that you would be missing without it.

3-Dimensional Imaging is revolutionizing dentistry. It is improving diagnosis and treatment in oral surgery, implant dentistry, orthodontics, and endondontics. Computed Tomography (CT) is not new, but with the development of CBCT units now available, these images can be produced with significantly less radiation exposure (50-100X) compared to medical CT, shorter scan times (10-15 seconds in the office), and lower cost.

The CBCT provides me with a road map of sorts to plan surgical treatment. With the ability to identify vital anatomic structures such as nerves and blood vessels, I am able to plan the best possible treatment while decreasing the risk of complications.

This is an excerpt from a QA that I did with a local magazine. I have had the opportunity over the last 4 years to incorporate CBCT and 3-Dimensional imaging into my practice. I have to say that this has completely changed my practice with regards to how I practice.

The images allow me to see things that were only available with tomograms or a medical CT. Medical CT’s are great, but are limited by very high cost, limited availability, and large radiation exposure to the patient.

The CBCT unit allows me to bring this to the office. The software programs available now, also allow for 3-D reconstructions that are difficult to obtain and manipulate with a medical CT. We have an Ewoo Master Superior large field of view CBCT in our office. This was the third unit of its kind in the United States.

We are seeing a shift in implant dentistry as CBCT is incorporated. It is rapidly becoming the standard of care in implant dentistry. This is due in part to the ability to identify potential problems due to bone volume, or the location of the maxillary sinus or inferior alveolar nerve. With the ability to take direct measurements off of CBCT images, this far exceeds what can be done with panoramic x-rays or periapical films.

Before you have a dental implant placed, you should ask your surgeon or dentist to have a CBCT. The benefit of the scan will far exceed the cost.

This is a question that I am asked on almost a daily basis. I generally answer this with a description of all of the things that I can do. The reaction generally follows with “you can do that”! I practice in a specialty that very few people truly understand.

This was no more evident than last week. I was evaluating someone for a dental implant that we had planned. As we were discussing the surgical instructions, she told me that she did not like the way that her earlobes looked and wondered if there was anything that could be done to fix this. I was pleasantly suprised by her question and then proceeded to show her how we could fix this. Her next question was “can we do this at the same time that I have my dental implant placed?” I explained that this was definitely possible and would actually be to her benefit since she was already going to have IV sedation for her implant placement. This would allow her to have both procedures done at the same time while only having to undergo one anesthetic.

She was extremely happy about this and scheduled surgery for the next morning. She left with a future tooth replacement and a younger set of ears.

Oral and Maxillofacial Surgery is a specialty of dentistry, but the typical oral surgeon functions more like a hybrid between medicine and dentistry. Having our roots in dentistry is what makes Oral and Maxillofacial Surgeons so technically adept at surgery. The hand eye coordination required to perform quality dentistry lends itself well to the practice of surgery.

Oral and Maxillofacial Surgery requires a minimum of 4 additional years of training in both medicine and surgery, while a number of us also complete medical school to become dual-degreed in both dentistry and medicine. This is not a new thing and encompasses approximately 40% of the current residency training.

From its roots in dentistry, Oral and Maxillofacial Surgery addresses numerous dental and oral procedures such as the removal of impacted teeth, placement of dental implants, intraoral bone grafting, and removal of pathology in the oral cavity. But the practice of Oral and Maxillofacial Surgery is not limited to the oral cavity.

Facial cosmetic surgery, cleft lip and palate surgery, orthognathic (corrective jaw) surgery, facial trauma and reconstructive surgery and head and neck cancer surgery can and do fall within the scope of the practicing Oral and Maxillofacial Surgeon.

Some medical specialties try to claim that they are the only ones qualified to perform some of these types of surgeries. I believe that this could not be farther from the truth, and misleads the public. The better question to ask your surgeon is “what experience and training do you have in these areas?” What you will likely find is that there is a significant amount of crossover between surgical subspecialties.

I am proud of the fact that I am a dentist first. My desire entering college was to pursue a career in dentistry. After being exposed to the practice of Oral and Maxillofacial Surgery, I immediately knew that this is what I was meant to do.

My training has allowed me to accomplish things far beyond the scope of dentistry and each day I am challenged to learn new things. This is what makes it fun. Everytime that I think I have seen it all, I am suprised with something new.

So the next time that your dentist or physician refers you to an Oral and Maxillofacial Surgeon, rest assured that you are in able hands.

Hello everyone. This is my first attempt at a blog, so bear with me. My goal with this blog is to provide a means of educating people about Oral and Maxillofacial Surgery. This is a profession that i am very passionate about and I hope that you will find this site beneficial.

Check back soon for more updates. You can also visit www.brazossurgery.com for more information about Oral and Maxillofacial Surgery and my practice

About Dr. Warren

Dr. Scott Warren is an Oral and Maxillofacial Surgeon practicing at Heart of the Brazos Oral and Facial Surgery in Waco, Texas.

He is a native of Waco, Texas. Dr. Warren completed his dental degree at Baylor College of Dentistry in Dallas, Texas where he graduated #1 in his class. He went on to obtain a medical degree from Texas Tech University School of Medicine in Lubbock, Texas.

Dr. Warren then completed an internship in General Surgery at Baylor University Medical Center in Dallas. He followed this up by completing his residency training in Oral and Maxillofacial Surgery at Baylor College of Dentistry/Baylor University Medical Center in Dallas, Texas.

Dr. Warren has an interest in dental implants and advanced bone grafting techniques, as well as, 3-D imaging using Cone Beam Computed Tomography. He practices a full scope of Oral and Maxillofacial Surgery in Waco, Texas.